Chủ Nhật, 12 tháng 1, 2014

Spinal Disc Herniation

Spinal Disc Herniation Several discs are present in the vertebral column which acts as a cushioning pad for reducing the impact of movement. Every disc has a central soft tissue surrounded by jelly like donut. When the central part (soft) gets ruptured it causes spinal disc herniation. Herniated disc present in the area between the 4th and 5th lumbar vertebral column are often affected.

Disc herniation can be diagnosed using imaging tests like X-ray, CT and MRI scanning. It can be treated by combination of medications and physiotherapy and in rare cases surgery is done.

Structure of Spine and Discs :

The spinal cord or the backbone is made up of many vertebrae which serve as the building blocks. Discs can be found between each vertebra surrounded by ligaments and tissues. There are seven vertebrae in the neck region called cervical vertebrae, twelve vertebrae in the middle of the spine and five vertebrae present in the lower back region called lumbar vertebrae. Below the 5th lumbar column sacrum is found and beneath that the tailbone called coccyx is present. These set of vertebrae provides support for the underlying spinal cord and protects it from injury.

The vertebra exists as a strong boney structure in front of the spine and serves as a cushion for bearing the weight. Ligaments are soft tissues that remain attached to the bones and to the vertebrae that surrounds the discs. Any injury to these ligaments can cause pain in the area. Spinal disc herniation can cause irritation to the nerves causing pain and weakness in your arm or leg.

Symptoms :

Some people may have herniated disc without any symptoms. They become aware of it only when they do imaging tests for some other purpose. The intensity of pain varies with the location of the herniated disk. Very often it can occur in the lumbar spine and sometimes on your neck region.

Some of the symptoms of spinal disc herniation include numbness and tingling sensation in the arms and legs if the nerves are affected severely. In case the herniated disk occurs in the neck region the pain is felt in the arm and on the shoulder region. The pain becomes intense when you sneeze or cough when the spine makes sudden movements.

For some people the muscles become very weak making it difficult to hold or lift certain heavy objects. If the herniated disc is very large then it will exert pressure on the spinal nerves causing intense pain on both sides of your body.

Causes :

Very often spinal disc herniation occurs due to gradual aging process that causes wear and tear of the disk. The spine becomes less flexible and becomes more prone to rupturing for even minor injury. Exact cause of disk herniation is not known. It can be due to wrong usage of back muscles for lifting heavy objects leading to twisting movements of the disk. Injury or trauma to the herniated disk can cause this problem. Many people will feel pain in the lower back region where the 4th or 5th lumbar vertebrae gets affected.

Who are at risk?

• Middle aged and old age people and obese people are more prone to disk herniation than others.

• Workers whose job demand lifting of heavy weights frequently and bending sideways can also get their disk herniated causing intense pain.

• Spinal disk herniation will not cause any complications.

• In rare cases the pain may intensify making it difficult to carry on routine activities.

• For some people it can cause loss of bowel control and difficulty in urinating.

Tests and Diagnoses :

After checking the symptoms your doctor may ask you to gently raise your legs in sitting posture. This will produce abnormal pain in the foot. Imaging tests like X-ray, CT scan or MRI scan is done for checking if the disk has herniated. EMG testing is also done for finding out if the nerves are being kept under pressure due to herniated disk.

Treatment :

For mild to moderate pain it is enough if you follow conservative treatments like sitting in appropriate positions and doing regular stretching exercise. Over the counter pain-killer medications can help you get relief from painful symptoms. Most people affected with spinal disc herniation will not go to doctor and will get better in couple of months by following the above regimen.

Non prescription medications like Advil, Motrin or Tylenol or naproxen can provide great relief from pain. Your doctor may prescribe narcotics like codeine or hydrocodone like Vicodin or Lortab. But it can cause side effects like nausea and constipation problem. Medications like Neurontin, Lyrica, cymbalta or ultram are nerve pain killers that are often given for most of the people having spinal disk herniation because of its minimal side effects. Some people use muscle relaxants like valium or Amrix for getting relief from pain.

Physiotherapists will teach you about the proper positions of bending and sitting to reduce the pain of herniated disk. Gradually your muscles will gain stability and improves the health of your lower spine. In a typical physiotherapy program you will be put on traction or given hot/cold massage or use electrical stimulation for giving maximum relief from pain.

Surgery is the last option for spinal disk herniation and is considered only when you are not responding to conservative treatments. In case you have any disk fragment pressurizing the nerve causing weakness you will have to undergo surgery. Some people having problems in doing routine activities due to disk pain are eligible for surgical procedure. The surgeon will gently remove the fragmented disk that is protruding from the vertebral column. For some people implantation of disk is done.

Home Remedies :

Most of the time it is enough if you take pain killers and over the counter medications for decreasing the painful episodes. You can try using hot/cold packs for reducing the inflammation. You need to avoid certain activities that increase the pain in the lower back.

Accept that you are having herniated disk pain and try to overcome it through various home remedies. Stress can directly increase the pain and hence do relaxation exercises and yoga/meditation to get relief from stress. You can get help from the counselor who will help you to change your perception regarding herniated pain.

Prevention :

Though you cannot prevent any accidental injury still you can avoid risk causing situations. Practice regular exercises to give support to the spine. Maintain good posture and avoid lifting heavy objects directly. You can shift the weight in your legs and not on your back. Reduce weight and have a healthy diet.

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